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From the 11/19/2021 release of VAERS data:

This is VAERS ID 1775378

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Case Details

VAERS ID: 1775378 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: California  
Vaccinated:2021-10-04
Onset:2021-10-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1822809 / N/A LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain, Blood test, Chest X-ray, Decreased appetite, Echocardiogram, Electrocardiogram, Fatigue, Headache, Insomnia, Mobility decreased, Muscle spasms, Nausea, Pain, Pallor, Paraesthesia, Sleep disorder, Vomiting
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Retroperitoneal fibrosis (broad), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypotonic-hyporesponsive episode (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamin a,c,d,zinc, tudca, minerals, magnesium, tumeric
Current Illness: none
Preexisting Conditions: migraines, infrequent but disturbs functioning, especially if untreated
Allergies: Augmentin, hemp seeds
Diagnostic Lab Data: 10/8/21 Ekg, Echo cardiogram, chest Xray, blood tests
CDC Split Type:

Write-up: 10/4/21 6pm Tingling sensation on soles of feet then on palms of hands ongoing high intensity for 24+hours then continuing a lower intensity on feet for 5+days; during first night sleep, whole body muscle spasms during the night causing pain which awakened from a deep sleep and resulted in body pain and fatigue upon awakening fully in the morning; 10/5/21 9am unrelenting nausea for 7 hours, non-responsive to prochlorperazine 10mg, leading to episode of vomiting at 3:00pm, then nausea responded at 7:00pm to Ondansetron 4mg; also at same time on 10/5/21 9am intense, unrelenting excruciating headache, lasting 7+ hours at a high intensity level SUD=9 (Subjective units of distress as compared up against severe migraines which untreated are SUD 7-8 and where labor pains were 9), then intermittent headaches for 5+ days; during this time 10/5/21 9-6 stillness, lying without getting up for 7 hours due to intense pain; sickly pallor about 5 hours; loss of appetite 24+hours, and low appetite for 5+days; intermittent abdominal pain, diminishing in frequency and intensity over time 5+days; 10/6/21 night - complete insomnia for 8 hours;


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